Article ; Online: COVID-19-associated pulmonary aspergillosis: a prospective single-center dual case series.
2021 Volume 64, Issue 4, Page(s) 457–464
Abstract: Background: COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as an invasive ... mortality.: Objectives: Here, we describe a single-centre prospective case series with CAPA cases ... Conclusions: In this series, 19.7% (n = 13/66) of mechanically ventilated SARS-CoV-2 patients were diagnosed ...
| Abstract | Background: COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as an invasive fungal disease, often affecting previously immunocompetent, mechanically ventilated, intensive care unit (ICU) patients. Incidence rates of 3.8%-33.3% have been reported depending on the geographic area, with high (47%) mortality. Objectives: Here, we describe a single-centre prospective case series with CAPA cases from both the first (March-May, n = 5/33) and second (mid-September through mid-December, n = 8/33) COVID-19 wave at a 500-bed teaching hospital in the Netherlands. Patients/methods: In the first COVID-19 wave, a total of 265 SARS-CoV-2 PCR-positive patients were admitted to our hospital of whom 33 needed intubation and mechanical ventilation. In the second wave, 508 SARS-CoV-2 PCR-positive patients were admitted of whom 33 needed mechanical ventilation. Data were prospectively collected. Results: We found a significant decrease in COVID-19 patients needing mechanical ventilation in the ICU in the second wave (p < .01). From these patients, however, a higher percentage were diagnosed with CAPA (24.2% vs 15.2%), although not significant (p = .36). All CAPA patients encountered in the second wave received dexamethasone. Mortality between both groups was similarly high (40%-50%). Moreover, we found environmental TR Conclusions: In this series, 19.7% (n = 13/66) of mechanically ventilated SARS-CoV-2 patients were diagnosed with CAPA. In addition, we found a significant reduction in COVID-19 patients needing mechanical ventilation on the ICU in the second wave. Numbers are too small to determine whether there is a true difference in CAPA incidence in mechanically ventilated patients between the two waves, and whether it could be attributed to dexamethasone SARS-CoV-2 therapy. |
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| MeSH term(s) | Aged ; COVID-19/complications ; COVID-19/diagnosis ; Cohort Studies ; Female ; Humans ; Intensive Care Units ; Male ; Netherlands/epidemiology ; Polymerase Chain Reaction ; Prospective Studies ; Pulmonary Aspergillosis/complications ; Pulmonary Aspergillosis/epidemiology ; Pulmonary Aspergillosis/etiology ; Pulmonary Aspergillosis/mortality ; Respiration, Artificial ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy ; SARS-CoV-2/genetics ; SARS-CoV-2/isolation & purification | |||||
| Language | English | |||||
| Publishing date | 2021-02-16 | |||||
| Publishing country | Germany | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 392487-7 | |||||
| ISSN | 1439-0507 ; 0933-7407 | |||||
| ISSN (online) | 1439-0507 | |||||
| ISSN | 0933-7407 | |||||
| DOI | 10.1111/myc.13254 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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